South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States.
South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States.
Child Abuse Negl. 2019 Jun;92:209-218. doi: 10.1016/j.chiabu.2019.04.010. Epub 2019 Apr 16.
The purpose of this study was to estimate the prevalence of adverse childhood experiences (ACEs) among children in the United States and to examine the relationship between child and family characteristics and the likelihood of reported exposure to ACEs.
Data were drawn from the nationally representative 2016 National Survey of Children's Health (NSCH). Parent-reported child ACE exposure was measured using counts of those reporting zero ACEs, one to three ACEs, and four or more ACEs.
The study sample included 45,287 children. The most prevalent types of ACE exposure experienced by children were economic hardship (22.5%) and parent or guardian divorce or separation (21.9%). Older children (34.7%), Non-Hispanic African American children (34.7%), children with special health care needs (SHCN; 36.3%), children living in poverty (37.2%), and children living in rural areas (30.5%) were more likely to be exposed to parental divorce or separation than their counterparts. Five cross-cutting factors emerged as important across outcomes: child's age, family structure, poverty, type of health insurance, and SHCN status.
We found high prevalence rates of economic hardship on a national level. Our findings of higher prevalence among rural children further suggest the importance of the intersection of place and ACEs. Therefore, the geographic component of ACEs must be considered by policymakers. The identification of predictive factors related to high ACE exposure can inform early interventions at the national level.
本研究旨在估计美国儿童不良童年经历（ACE）的流行率，并探讨儿童和家庭特征与报告的 ACE 暴露之间的关系。
数据来自具有全国代表性的 2016 年全国儿童健康调查（NSCH）。使用报告无 ACE、1-3 个 ACE 和 4 个或更多 ACE 的父母人数来衡量儿童 ACE 暴露情况。
研究样本包括 45287 名儿童。儿童经历的最常见 ACE 暴露类型是经济困难（22.5%）和父母或监护人离婚或分居（21.9%）。年龄较大的儿童（34.7%）、非西班牙裔非裔美国儿童（34.7%）、有特殊医疗需求的儿童（36.3%）、生活在贫困中的儿童（37.2%）和生活在农村地区的儿童（30.5%）比同龄人更有可能经历父母离婚或分居。五个交叉因素在所有结果中都显得很重要：儿童年龄、家庭结构、贫困、医疗保险类型和特殊健康状况儿童的状况。
我们发现全国范围内经济困难的发生率很高。我们发现农村儿童的发生率较高，这进一步表明了地点和 ACE 交叉的重要性。因此，政策制定者必须考虑 ACE 的地理组成部分。与高 ACE 暴露相关的预测因素的确定可以为国家一级的早期干预提供信息。
